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Objective: Invasive breast cancer is a heterogeneous disease group that has different biological and pathological features, and characterized with different clinical behavior, treatment results, and consequences. The rarity of most specific neoplasies does not allow large or randomized studies to determine optimal treatment. With this study, we aimed to evaluate the clinical and pathological features and treatment options and results of rare breast carcinoma patients that followed and treated in our clinic. Methods: Files of 1280 breast cancer patients admitted to our center between years 2000 and 2016 were evaluated. From these patients, who have rare breast carcinoma subtypes were included and patients with pathological diagnosis of invasive ductal carcinoma and invasive lobular carcinoma were excluded. Seventy-three patients that included in the study were analyzed retrospectively in terms of age, menopausal status, family history, tumor-lymph node-metastasis stage, histological grade, hormone receptor level, human epidermal growth factor receptor2 expression, operation type and overall survival (OS). Results: Eight histological subtypes of breast tumors were evaluated. Significant difference wasn't found between groups in terms of mean age of the patients. In terms of histological subtypes, the most eldest patients were in papillary group, the youngest patients were in tubular group. The mean tumor diameter was also significantly different between groups (p=0.02). The mean age of the patients diagnosed with tubular and mucinous type breast carcinomas were younger than the one reported in literature and the mean tumor diameter was also larger in these tumors. Ratio of patients diagnosed at advanced stages was high (43%). While mucinous and tubular carcinomas were the histological subtypes with the best prognosis, the shortest OS was in primary breast sarcoma and neuroendocrine carcinoma group. Conclusion: Rare breast cancers are a heterogeneous malignity group with different behavior and prognosis. Our results, except some cases, were generally concordant with the data obtained from other studies. These exceptions may be related to race, regional factors, different pathological evaluation, and environmental factors. Nevertheless, comprehensive clinical studies are required because of the rare occurrence these tumors. [ABSTRACT FROM AUTHOR]

Objective: Ki67 is a nuclear protein that is expressed in all phases of the cell cycle except for G0. It is used as a marker to detect the proliferating cells. It has been shown that Ki-67 labeling index is associated with poor clinical outcome in patients with breast cancer. In this study, we aimed to evaluate the prognostic significance of Ki-67 labeling index in patients with estrogen receptor and progesterone receptor positive, HER-2 negative and axillary lymph node negative breast cancer. Methods: Patients diagnosed with breast cancer during 2006-2014, and who were followed up in the medical oncology clinic were included in the study. Immunohistochemically, nuclear Ki-67 proliferation index was evaluated. The relationship with other clinicopathologic prognostic factors was evaluated. Results: 162 patients were included in the study. In a median 85 (9-132)-months follow¬up, local recurrence was detected in 2(1.2%) patients and distant metastasis was detected in 7(4.3%) patients. Eight (4.9%) patients died. Patients were divided into two groups using 20% cut-off value for Ki-67 labelling index, obtained by Roc curve analysis. The 7-year overall survival was 97.1% in the group with Ki-67 labeling index below 20%, while it was 90.9% in the group above the 20% value (p=0.042). Ki-67 labeling index showed positive correlation with tumor histological grade, and pathologic tumor size, and negative correlation with hormone receptors. Conclusion: Proliferation is an important indicator for predicting prognosis and treatment response in breast cancer. Ki-67 labeling index is used to determine prognosis along with other clinicopathological prognostic factors, although there is no standard cut-off value and no standard of assessment and no standard in scoring methodology. [ABSTRACT FROM AUTHOR]

Objective: Determining the Her2 (human epidermal growth factor receptor 2) status which is one of the prognostic criteria in patients with invasive breast cancer is an important factor. The patients with Her2 3+ and Her2 2+/amplified are treated with anti-Her2 treatment. The patients with Her2 2+/non-amplified are not treated with anti-Her2 treatment. In this study; The patients with Her2 2+/amplified and Her2 2+/non-amplified were compared in terms of histopathologic prognostic parameters. Thus, we aimed to determine the prognostic status of the Her2 2+/ nonamplified group. Methods: A total of 76 breast cancer patients were retrospectively included in this study. Tumor hormonal receptor phenotype, age, grade, lymphovascular invasion, perineural invasion, axillary lymph node status were determined. The study was focused on Her2 2+/amplified and Her2 2+/nonamplified tumors. Her2 expression status was analyzed using ASCO/CAP (American Society of Clinical Oncology/College of American Pathologists) guidelines. Results: There was no statistically significant difference between the patients with Her2 2+/amplified and Her2 2+/non-amplified in terms of many histopathological parameters. Only the progesterone expression ratios of Her2 2+/non-amplified group were higher than others (p=0.001) Conclusion: Her2 2+/non-amplified patients have similar results in terms of histopathological prognostic parameters with both Her2 2 +/amplified patients and Her2 (+) and Her2 (-) patients. More lymphovascular invasion rates were detected as Her2 positivity increased. The present study includes results consistent with studies advocating the necessity of taking all Her2(+) cases into anti-Her2 treatment. We at least think that all Her2 2+ patients should receive anti-Her2 therapy regardless of the amplification [ABSTRACT FROM AUTHOR]

Objective: The association of breast cancer and thyroid autoimmunity has been suggested by many studies in the literature, but the causality still needed to be proven. With this study we aimed to search the correlation between thyroid autoimmunity and breast cancer prognostic factors. Materials and Methods: To this prospective cohort study 200 consecutive breast cancer patients, who were operated in our clinic were included. Patients' serum thyroid hormone, anti-thyroglobuline (anti-TG) and antithyroid peroxidase (anti-TPO) levels and tumors' prognostic parameters (tumor size, axillary involvement, histological grade, lymphovascular invasion, receptor status, Ki-67 proliferation index) were collected. The correlation between serum thyroid autoantibody levels and tumor's prognostic factors were studied. Results: The prevalence of thyroid autoimmunity (high levels of serum anti-TPO and/or anti-TG) was 18.5% (n=37). Patients with thyroid autoimmunity had a significant lower rate of axillary involvement and a lower rate of Ki-67 proliferation index (22% vs. 46% [p=0,007] and 12.73% vs. 20.72% [p=0.025], respectively) and were more commonly included to the "low-risk" group (<14%) according to their Ki-67 scores (68% vs. 46%; p=0.015). Other parameters did not differ between the two groups. Conclusion: We found a favorable correlation between thyroid autoimmunity and axillary involvement and also Ki-67 proliferation index score, which are two crucial and strongly predictive parameters of breast cancer prognoses. This supports the idea of thyroid autoimmunity being a favorable prognostic parameter. Further studies are necessary to investigate the reasons of protective or predictive effect of high thyroid peroxidase levels in breast cancer patients. [ABSTRACT FROM AUTHOR]

Objective: Socioeconomic and cultural factors influence breast cancer prognosis. The effect of these factors on breast cancer was evaluated among women who live in Gaziantep and its surroundings. Materials and Methods: female patients who were admitted to Gaziantep University Oncology Hospital with a diagnosis of breast cancer between October 2006-July 2013 were included in the study. The effects of socio-demographic characteristics on clinical-pathological features were evaluated. Results: The mean age of 813 women was 48.8 years. The majority were premenopausal women. Advanced stage disease on diagnosis was detected more in our region. The rate of breast cancer with unfavorable prognostic features was higher among patients who were illiterate, with low economic income and residing in rural areas. Conclusion: Socioeconomic-cultural factors influence the biology and clinical course of breast cancer among women who live in Gaziantep province. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate HER-2 gene amplification ratio in c-erbB-2score 2 breast carcinoma cases which have been controversial for targeted terapy and determinate its correlation with pathologic prognostic factors. Material and Method: We analyzed 80 infiltrating breast carcinomas, which were immunohistochemically score 2 with silver in situ hybridization (SISH) assay to determine Her-2 gene amplification. Afterwards cases have been grouped as amplification positive (AP) and amplification negative (AN). These groups have been compared with each other to reveal their relationship with pathologic prognostic factors. Results: 30% of the cases showed HER-2 gene amplification with SISH. Median age of patients in AP group was 50.3 (±11.4). Median age of AN group was 56.7 (±13.0). We found that tumors in AP group had much higher mitotic rate (p= 0.044). Mean metastatic lenf node number in AP group was 10, while it was only 1 in AN group. Lenfovascular invasion was the other striking parameter which showed statisticaly significant correlation with HER-2 amplification. We didn't find any statisticaly significant correlation between HER-2 amplification and tumor size, histologic grade, nuclear grade, diameter of the largest metastatic lenf node, steroid receptor expression and tumor necrosis. Conclusion: Tumors that show HER-2 gene amplification have much higher mitotic rate, increased metastatic lenf node number and increased lenfovascular invasion rate. Unignorable part of controversial immunohistochemically c-erbB-2 score 2 cases show HER-2 gene amplification and we need to confirm these cases with genetic tests. SISH is a cheap, easy and cantitative alternative. [ABSTRACT FROM AUTHOR]

Intracystic papillary carcinoma of the breast (IPC) is usually seen in postmenopausal elderly women. Its prognosis is much better than other type of breast tumors, and usually do not contain invasive components. Surgical excision with negative margins and axillary sentinel lymph node sampling is the recommended treatment. Two cases of intracystic papillary carcinoma of the breast that was treated at our clinic are herein presented. Both cases were postmenopausal, were both positive for estrogen and progesterone receptors and negative for HER 2. They underwent breast-conserving surgery. One patient had an invasive focus, therefore axillary lymph node sampling was performed, and the sentinel lymph node was not metastatic. This patient received hormonal therapy as well as radiotherapy. In the other case, there was no invasive focus and the surgical margins were negative, therefore, additional surgery was not performed. The patient is receiving hormonal therapy. Intracystic carcinoma of the breast should be kept in mind especially in elderly patients with breast cysts, with clinically or radiologically suspicious features, and biopsy and local excision should be considered. Although there is not any standard approach for patients with IPC, each patient must be evaluated for surgery and should be individually assessed in terms of adjuvant therapy [ABSTRACT FROM AUTHOR]